FA-64416 / Clinical triage scoring / Open access
Five-level emergency acuity assignment: severe pain threshold · case 01
A patient reporting pain 7/10 is not moved to level 2.
ROOT CAUSE
The severe pain rule uses > 7.
VERIFIED REPAIR
Assign level 2 for pain >= 7 regardless of resources.
Unsuccessful approach: Requiring two resources as well leaves low-resource patients in severe pain at level 4 or 5.
Case contract
Input {lifesaving, high_risk, confused, pain (0-10), resources, age_years, hr, rr, spo2}. Toy algorithm: lifesaving intervention -> 1; high risk, confusion or pain >= 7 -> 2; otherwise resources 0 -> 5, 1 -> 4, >= 2 -> 3, except that patients needing >= 2 resources with danger-zone vitals are upgraded to 2. Danger zone: spo2 < 92 or hr/rr above age limits (age < 1: 180/50; 1-2: 160/40; 3-7: 140/30; 8+: 100/20). Return {level, upgraded}.
Why this case matters
Acuity algorithms are ordered decision trees with age-dependent vital limits; each branch condition is a separate defect site.
1 / The failure
Exit 1"""Failure Map reference implementation. Python standard library only."""
import json
N = 1
observations = []
def solve(x):
if x['lifesaving']:
return {'level': 1, 'upgraded': False}
if x['high_risk'] or x['confused'] or x['pain'] > 7:
return {'level': 2, 'upgraded': False}
r, a = x['resources'], x['age_years']
if a < 1:
hr_lim, rr_lim = 180, 50
elif a < 3:
hr_lim, rr_lim = 160, 40
elif a < 8:
hr_lim, rr_lim = 140, 30
else:
hr_lim, rr_lim = 100, 20
danger = x['hr'] > hr_lim or x['rr'] > rr_lim or x['spo2'] < 92
if r >= 2 and danger:
return {'level': 2, 'upgraded': True}
return {'level': 3 if r >= 2 else 4 if r == 1 else 5, 'upgraded': False}
def check(label, actual, expected):
observations.append({"check": label, "actual": actual, "expected": expected, "passed": actual == expected})
fixtures = [[('lifesaving',
{'lifesaving': True,
'high_risk': True,
'confused': False,
'pain': 3,
'resources': 3,
'age_years': 41,
'hr': 130,
'rr': 30,
'spo2': 85},
{'level': 1, 'upgraded': False}),
('severe pain exactly 7',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 7,
'resources': 1,
'age_years': 30,
'hr': 90,
'rr': 18,
'spo2': 98},
{'level': 2, 'upgraded': False}),
('two resources normal vitals',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 4,
'resources': 3,
'age_years': 35,
'hr': 88,
'rr': 18,
'spo2': 97},
{'level': 3, 'upgraded': False}),
('one resource tachycardic stays 4',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 2,
'resources': 1,
'age_years': 25,
'hr': 106,
'rr': 18,
'spo2': 97},
{'level': 4, 'upgraded': False}),
('no resources hypoxic stays 5',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 0,
'resources': 0,
'age_years': 50,
'hr': 80,
'rr': 18,
'spo2': 89},
{'level': 5, 'upgraded': False}),
('eight-year-old uses adult limits',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 8,
'hr': 111,
'rr': 22,
'spo2': 97},
{'level': 2, 'upgraded': True}),
('twelve-year-old uses adult limits',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 3,
'age_years': 12,
'hr': 116,
'rr': 18,
'spo2': 98},
{'level': 2, 'upgraded': True}),
('preschool child within limits',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 4,
'hr': 131,
'rr': 28,
'spo2': 97},
{'level': 3, 'upgraded': False}),
('saturation exactly 92',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 61,
'hr': 80,
'rr': 18,
'spo2': 92},
{'level': 3, 'upgraded': False}),
('hypoxic child with two resources',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 1,
'hr': 120,
'rr': 25,
'spo2': 90},
{'level': 2, 'upgraded': True})],
[('lifesaving',
{'lifesaving': True,
'high_risk': True,
'confused': False,
'pain': 3,
'resources': 3,
'age_years': 42,
'hr': 130,
'rr': 30,
'spo2': 85},
{'level': 1, 'upgraded': False}),
('severe pain exactly 7',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 7,
'resources': 0,
'age_years': 30,
'hr': 90,
'rr': 18,
'spo2': 98},
{'level': 2, 'upgraded': False}),
('two resources normal vitals',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 4,
'resources': 2,
'age_years': 35,
'hr': 88,
'rr': 18,
'spo2': 97},
{'level': 3, 'upgraded': False}),
('one resource tachycardic stays 4',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 2,
'resources': 1,
'age_years': 25,
'hr': 107,
'rr': 18,
'spo2': 97},
{'level': 4, 'upgraded': False}),
('no resources hypoxic stays 5',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 0,
'resources': 0,
'age_years': 50,
'hr': 80,
'rr': 18,
'spo2': 90},
{'level': 5, 'upgraded': False}),
('eight-year-old uses adult limits',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 8,
'hr': 112,
'rr': 22,
'spo2': 97},
{'level': 2, 'upgraded': True}),
('twelve-year-old uses adult limits',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 3,
'age_years': 12,
'hr': 117,
'rr': 18,
'spo2': 98},
{'level': 2, 'upgraded': True}),
('preschool child within limits',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 4,
'hr': 132,
'rr': 28,
'spo2': 97},
{'level': 3, 'upgraded': False}),
('saturation exactly 92',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 62,
'hr': 80,
'rr': 18,
'spo2': 92},
{'level': 3, 'upgraded': False}),
('hypoxic child with two resources',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 2,
'hr': 120,
'rr': 25,
'spo2': 90},
{'level': 2, 'upgraded': True})],
[('lifesaving',
{'lifesaving': True,
'high_risk': True,
'confused': False,
'pain': 3,
'resources': 3,
'age_years': 43,
'hr': 130,
'rr': 30,
'spo2': 85},
{'level': 1, 'upgraded': False}),
('severe pain exactly 7',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 7,
'resources': 1,
'age_years': 30,
'hr': 90,
'rr': 18,
'spo2': 98},
{'level': 2, 'upgraded': False}),
('two resources normal vitals',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 4,
'resources': 3,
'age_years': 35,
'hr': 88,
'rr': 18,
'spo2': 97},
{'level': 3, 'upgraded': False}),
('one resource tachycardic stays 4',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 2,
'resources': 1,
'age_years': 25,
'hr': 108,
'rr': 18,
'spo2': 97},
{'level': 4, 'upgraded': False}),
('no resources hypoxic stays 5',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 0,
'resources': 0,
'age_years': 50,
'hr': 80,
'rr': 18,
'spo2': 89},
{'level': 5, 'upgraded': False}),
('eight-year-old uses adult limits',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 8,
'hr': 113,
'rr': 22,
'spo2': 97},
{'level': 2, 'upgraded': True}),
('twelve-year-old uses adult limits',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 3,
'age_years': 12,
'hr': 118,
'rr': 18,
'spo2': 98},
{'level': 2, 'upgraded': True}),
('preschool child within limits',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 4,
'hr': 133,
'rr': 28,
'spo2': 97},
{'level': 3, 'upgraded': False}),
('saturation exactly 92',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 63,
'hr': 80,
'rr': 18,
'spo2': 92},
{'level': 3, 'upgraded': False}),
('hypoxic child with two resources',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 3,
'hr': 120,
'rr': 25,
'spo2': 90},
{'level': 2, 'upgraded': True})],
[('lifesaving',
{'lifesaving': True,
'high_risk': True,
'confused': False,
'pain': 3,
'resources': 3,
'age_years': 44,
'hr': 130,
'rr': 30,
'spo2': 85},
{'level': 1, 'upgraded': False}),
('severe pain exactly 7',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 7,
'resources': 0,
'age_years': 30,
'hr': 90,
'rr': 18,
'spo2': 98},
{'level': 2, 'upgraded': False}),
('two resources normal vitals',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 4,
'resources': 2,
'age_years': 35,
'hr': 88,
'rr': 18,
'spo2': 97},
{'level': 3, 'upgraded': False}),
('one resource tachycardic stays 4',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 2,
'resources': 1,
'age_years': 25,
'hr': 109,
'rr': 18,
'spo2': 97},
{'level': 4, 'upgraded': False}),
('no resources hypoxic stays 5',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 0,
'resources': 0,
'age_years': 50,
'hr': 80,
'rr': 18,
'spo2': 90},
{'level': 5, 'upgraded': False}),
('eight-year-old uses adult limits',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 8,
'hr': 114,
'rr': 22,
'spo2': 97},
{'level': 2, 'upgraded': True}),
('twelve-year-old uses adult limits',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 3,
'age_years': 12,
'hr': 119,
'rr': 18,
'spo2': 98},
{'level': 2, 'upgraded': True}),
('preschool child within limits',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 4,
'hr': 134,
'rr': 28,
'spo2': 97},
{'level': 3, 'upgraded': False}),
('saturation exactly 92',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 64,
'hr': 80,
'rr': 18,
'spo2': 92},
{'level': 3, 'upgraded': False}),
('hypoxic child with two resources',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 4,
'hr': 120,
'rr': 25,
'spo2': 90},
{'level': 2, 'upgraded': True})],
[('lifesaving',
{'lifesaving': True,
'high_risk': True,
'confused': False,
'pain': 3,
'resources': 3,
'age_years': 45,
'hr': 130,
'rr': 30,
'spo2': 85},
{'level': 1, 'upgraded': False}),
('severe pain exactly 7',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 7,
'resources': 1,
'age_years': 30,
'hr': 90,
'rr': 18,
'spo2': 98},
{'level': 2, 'upgraded': False}),
('two resources normal vitals',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 4,
'resources': 3,
'age_years': 35,
'hr': 88,
'rr': 18,
'spo2': 97},
{'level': 3, 'upgraded': False}),
('one resource tachycardic stays 4',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 2,
'resources': 1,
'age_years': 25,
'hr': 110,
'rr': 18,
'spo2': 97},
{'level': 4, 'upgraded': False}),
('no resources hypoxic stays 5',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 0,
'resources': 0,
'age_years': 50,
'hr': 80,
'rr': 18,
'spo2': 89},
{'level': 5, 'upgraded': False}),
('eight-year-old uses adult limits',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 8,
'hr': 115,
'rr': 22,
'spo2': 97},
{'level': 2, 'upgraded': True}),
('twelve-year-old uses adult limits',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 3,
'age_years': 12,
'hr': 120,
'rr': 18,
'spo2': 98},
{'level': 2, 'upgraded': True}),
('preschool child within limits',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 4,
'hr': 135,
'rr': 28,
'spo2': 97},
{'level': 3, 'upgraded': False}),
('saturation exactly 92',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 65,
'hr': 80,
'rr': 18,
'spo2': 92},
{'level': 3, 'upgraded': False}),
('hypoxic child with two resources',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 5,
'hr': 120,
'rr': 25,
'spo2': 90},
{'level': 2, 'upgraded': True})]]
for label, args, expected in fixtures[N-1]:
check(label, solve(args), expected)
print(json.dumps({"observations": observations, "passed": all(x["passed"] for x in observations)}, ensure_ascii=False))
raise SystemExit(0 if all(x["passed"] for x in observations) else 1)
| Boundary fixture | Actual | Expected | Outcome |
|---|---|---|---|
| lifesaving | {'level': 1, 'upgraded': False} | {'level': 1, 'upgraded': False} | Passed |
| severe pain exactly 7 | {'level': 4, 'upgraded': False} | {'level': 2, 'upgraded': False} | Failed |
| two resources normal vitals | {'level': 3, 'upgraded': False} | {'level': 3, 'upgraded': False} | Passed |
| one resource tachycardic stays 4 | {'level': 4, 'upgraded': False} | {'level': 4, 'upgraded': False} | Passed |
| no resources hypoxic stays 5 | {'level': 5, 'upgraded': False} | {'level': 5, 'upgraded': False} | Passed |
| eight-year-old uses adult limits | {'level': 2, 'upgraded': True} | {'level': 2, 'upgraded': True} | Passed |
| twelve-year-old uses adult limits | {'level': 2, 'upgraded': True} | {'level': 2, 'upgraded': True} | Passed |
| preschool child within limits | {'level': 3, 'upgraded': False} | {'level': 3, 'upgraded': False} | Passed |
| saturation exactly 92 | {'level': 3, 'upgraded': False} | {'level': 3, 'upgraded': False} | Passed |
| hypoxic child with two resources | {'level': 2, 'upgraded': True} | {'level': 2, 'upgraded': True} | Passed |
SHA-256 / 0e00bc19db29c61983b7f1722819b4ba8866440213596e46c6228b94b2f544d4
2 / The unsuccessful fix
Exit 1"""Failure Map reference implementation. Python standard library only."""
import json
N = 1
observations = []
def solve(x):
if x['lifesaving']:
return {'level': 1, 'upgraded': False}
if x['high_risk'] or x['confused'] or x['pain'] >= 7 and x['resources'] >= 2:
return {'level': 2, 'upgraded': False}
r, a = x['resources'], x['age_years']
if a < 1:
hr_lim, rr_lim = 180, 50
elif a < 3:
hr_lim, rr_lim = 160, 40
elif a < 8:
hr_lim, rr_lim = 140, 30
else:
hr_lim, rr_lim = 100, 20
danger = x['hr'] > hr_lim or x['rr'] > rr_lim or x['spo2'] < 92
if r >= 2 and danger:
return {'level': 2, 'upgraded': True}
return {'level': 3 if r >= 2 else 4 if r == 1 else 5, 'upgraded': False}
def check(label, actual, expected):
observations.append({"check": label, "actual": actual, "expected": expected, "passed": actual == expected})
fixtures = [[('lifesaving',
{'lifesaving': True,
'high_risk': True,
'confused': False,
'pain': 3,
'resources': 3,
'age_years': 41,
'hr': 130,
'rr': 30,
'spo2': 85},
{'level': 1, 'upgraded': False}),
('severe pain exactly 7',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 7,
'resources': 1,
'age_years': 30,
'hr': 90,
'rr': 18,
'spo2': 98},
{'level': 2, 'upgraded': False}),
('two resources normal vitals',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 4,
'resources': 3,
'age_years': 35,
'hr': 88,
'rr': 18,
'spo2': 97},
{'level': 3, 'upgraded': False}),
('one resource tachycardic stays 4',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 2,
'resources': 1,
'age_years': 25,
'hr': 106,
'rr': 18,
'spo2': 97},
{'level': 4, 'upgraded': False}),
('no resources hypoxic stays 5',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 0,
'resources': 0,
'age_years': 50,
'hr': 80,
'rr': 18,
'spo2': 89},
{'level': 5, 'upgraded': False}),
('eight-year-old uses adult limits',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 8,
'hr': 111,
'rr': 22,
'spo2': 97},
{'level': 2, 'upgraded': True}),
('twelve-year-old uses adult limits',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 3,
'age_years': 12,
'hr': 116,
'rr': 18,
'spo2': 98},
{'level': 2, 'upgraded': True}),
('preschool child within limits',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 4,
'hr': 131,
'rr': 28,
'spo2': 97},
{'level': 3, 'upgraded': False}),
('saturation exactly 92',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 61,
'hr': 80,
'rr': 18,
'spo2': 92},
{'level': 3, 'upgraded': False}),
('hypoxic child with two resources',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 1,
'hr': 120,
'rr': 25,
'spo2': 90},
{'level': 2, 'upgraded': True})],
[('lifesaving',
{'lifesaving': True,
'high_risk': True,
'confused': False,
'pain': 3,
'resources': 3,
'age_years': 42,
'hr': 130,
'rr': 30,
'spo2': 85},
{'level': 1, 'upgraded': False}),
('severe pain exactly 7',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 7,
'resources': 0,
'age_years': 30,
'hr': 90,
'rr': 18,
'spo2': 98},
{'level': 2, 'upgraded': False}),
('two resources normal vitals',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 4,
'resources': 2,
'age_years': 35,
'hr': 88,
'rr': 18,
'spo2': 97},
{'level': 3, 'upgraded': False}),
('one resource tachycardic stays 4',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 2,
'resources': 1,
'age_years': 25,
'hr': 107,
'rr': 18,
'spo2': 97},
{'level': 4, 'upgraded': False}),
('no resources hypoxic stays 5',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 0,
'resources': 0,
'age_years': 50,
'hr': 80,
'rr': 18,
'spo2': 90},
{'level': 5, 'upgraded': False}),
('eight-year-old uses adult limits',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 8,
'hr': 112,
'rr': 22,
'spo2': 97},
{'level': 2, 'upgraded': True}),
('twelve-year-old uses adult limits',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 3,
'age_years': 12,
'hr': 117,
'rr': 18,
'spo2': 98},
{'level': 2, 'upgraded': True}),
('preschool child within limits',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 4,
'hr': 132,
'rr': 28,
'spo2': 97},
{'level': 3, 'upgraded': False}),
('saturation exactly 92',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 62,
'hr': 80,
'rr': 18,
'spo2': 92},
{'level': 3, 'upgraded': False}),
('hypoxic child with two resources',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 2,
'hr': 120,
'rr': 25,
'spo2': 90},
{'level': 2, 'upgraded': True})],
[('lifesaving',
{'lifesaving': True,
'high_risk': True,
'confused': False,
'pain': 3,
'resources': 3,
'age_years': 43,
'hr': 130,
'rr': 30,
'spo2': 85},
{'level': 1, 'upgraded': False}),
('severe pain exactly 7',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 7,
'resources': 1,
'age_years': 30,
'hr': 90,
'rr': 18,
'spo2': 98},
{'level': 2, 'upgraded': False}),
('two resources normal vitals',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 4,
'resources': 3,
'age_years': 35,
'hr': 88,
'rr': 18,
'spo2': 97},
{'level': 3, 'upgraded': False}),
('one resource tachycardic stays 4',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 2,
'resources': 1,
'age_years': 25,
'hr': 108,
'rr': 18,
'spo2': 97},
{'level': 4, 'upgraded': False}),
('no resources hypoxic stays 5',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 0,
'resources': 0,
'age_years': 50,
'hr': 80,
'rr': 18,
'spo2': 89},
{'level': 5, 'upgraded': False}),
('eight-year-old uses adult limits',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 8,
'hr': 113,
'rr': 22,
'spo2': 97},
{'level': 2, 'upgraded': True}),
('twelve-year-old uses adult limits',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 3,
'age_years': 12,
'hr': 118,
'rr': 18,
'spo2': 98},
{'level': 2, 'upgraded': True}),
('preschool child within limits',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 4,
'hr': 133,
'rr': 28,
'spo2': 97},
{'level': 3, 'upgraded': False}),
('saturation exactly 92',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 63,
'hr': 80,
'rr': 18,
'spo2': 92},
{'level': 3, 'upgraded': False}),
('hypoxic child with two resources',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 3,
'hr': 120,
'rr': 25,
'spo2': 90},
{'level': 2, 'upgraded': True})],
[('lifesaving',
{'lifesaving': True,
'high_risk': True,
'confused': False,
'pain': 3,
'resources': 3,
'age_years': 44,
'hr': 130,
'rr': 30,
'spo2': 85},
{'level': 1, 'upgraded': False}),
('severe pain exactly 7',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 7,
'resources': 0,
'age_years': 30,
'hr': 90,
'rr': 18,
'spo2': 98},
{'level': 2, 'upgraded': False}),
('two resources normal vitals',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 4,
'resources': 2,
'age_years': 35,
'hr': 88,
'rr': 18,
'spo2': 97},
{'level': 3, 'upgraded': False}),
('one resource tachycardic stays 4',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 2,
'resources': 1,
'age_years': 25,
'hr': 109,
'rr': 18,
'spo2': 97},
{'level': 4, 'upgraded': False}),
('no resources hypoxic stays 5',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 0,
'resources': 0,
'age_years': 50,
'hr': 80,
'rr': 18,
'spo2': 90},
{'level': 5, 'upgraded': False}),
('eight-year-old uses adult limits',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 8,
'hr': 114,
'rr': 22,
'spo2': 97},
{'level': 2, 'upgraded': True}),
('twelve-year-old uses adult limits',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 3,
'age_years': 12,
'hr': 119,
'rr': 18,
'spo2': 98},
{'level': 2, 'upgraded': True}),
('preschool child within limits',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 4,
'hr': 134,
'rr': 28,
'spo2': 97},
{'level': 3, 'upgraded': False}),
('saturation exactly 92',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 64,
'hr': 80,
'rr': 18,
'spo2': 92},
{'level': 3, 'upgraded': False}),
('hypoxic child with two resources',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 4,
'hr': 120,
'rr': 25,
'spo2': 90},
{'level': 2, 'upgraded': True})],
[('lifesaving',
{'lifesaving': True,
'high_risk': True,
'confused': False,
'pain': 3,
'resources': 3,
'age_years': 45,
'hr': 130,
'rr': 30,
'spo2': 85},
{'level': 1, 'upgraded': False}),
('severe pain exactly 7',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 7,
'resources': 1,
'age_years': 30,
'hr': 90,
'rr': 18,
'spo2': 98},
{'level': 2, 'upgraded': False}),
('two resources normal vitals',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 4,
'resources': 3,
'age_years': 35,
'hr': 88,
'rr': 18,
'spo2': 97},
{'level': 3, 'upgraded': False}),
('one resource tachycardic stays 4',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 2,
'resources': 1,
'age_years': 25,
'hr': 110,
'rr': 18,
'spo2': 97},
{'level': 4, 'upgraded': False}),
('no resources hypoxic stays 5',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 0,
'resources': 0,
'age_years': 50,
'hr': 80,
'rr': 18,
'spo2': 89},
{'level': 5, 'upgraded': False}),
('eight-year-old uses adult limits',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 8,
'hr': 115,
'rr': 22,
'spo2': 97},
{'level': 2, 'upgraded': True}),
('twelve-year-old uses adult limits',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 3,
'age_years': 12,
'hr': 120,
'rr': 18,
'spo2': 98},
{'level': 2, 'upgraded': True}),
('preschool child within limits',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 4,
'hr': 135,
'rr': 28,
'spo2': 97},
{'level': 3, 'upgraded': False}),
('saturation exactly 92',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 65,
'hr': 80,
'rr': 18,
'spo2': 92},
{'level': 3, 'upgraded': False}),
('hypoxic child with two resources',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 5,
'hr': 120,
'rr': 25,
'spo2': 90},
{'level': 2, 'upgraded': True})]]
for label, args, expected in fixtures[N-1]:
check(label, solve(args), expected)
print(json.dumps({"observations": observations, "passed": all(x["passed"] for x in observations)}, ensure_ascii=False))
raise SystemExit(0 if all(x["passed"] for x in observations) else 1)
| Boundary fixture | Actual | Expected | Outcome |
|---|---|---|---|
| lifesaving | {'level': 1, 'upgraded': False} | {'level': 1, 'upgraded': False} | Passed |
| severe pain exactly 7 | {'level': 4, 'upgraded': False} | {'level': 2, 'upgraded': False} | Failed |
| two resources normal vitals | {'level': 3, 'upgraded': False} | {'level': 3, 'upgraded': False} | Passed |
| one resource tachycardic stays 4 | {'level': 4, 'upgraded': False} | {'level': 4, 'upgraded': False} | Passed |
| no resources hypoxic stays 5 | {'level': 5, 'upgraded': False} | {'level': 5, 'upgraded': False} | Passed |
| eight-year-old uses adult limits | {'level': 2, 'upgraded': True} | {'level': 2, 'upgraded': True} | Passed |
| twelve-year-old uses adult limits | {'level': 2, 'upgraded': True} | {'level': 2, 'upgraded': True} | Passed |
| preschool child within limits | {'level': 3, 'upgraded': False} | {'level': 3, 'upgraded': False} | Passed |
| saturation exactly 92 | {'level': 3, 'upgraded': False} | {'level': 3, 'upgraded': False} | Passed |
| hypoxic child with two resources | {'level': 2, 'upgraded': True} | {'level': 2, 'upgraded': True} | Passed |
SHA-256 / 14c929fa4f7d28d98f8695931de388cdbe26f3e0b2be706c84560216120d1e72
3 / The verified repair
Exit 0"""Failure Map reference implementation. Python standard library only."""
import json
N = 1
observations = []
def solve(x):
if x['lifesaving']:
return {'level': 1, 'upgraded': False}
if x['high_risk'] or x['confused'] or x['pain'] >= 7:
return {'level': 2, 'upgraded': False}
r, a = x['resources'], x['age_years']
if a < 1:
hr_lim, rr_lim = 180, 50
elif a < 3:
hr_lim, rr_lim = 160, 40
elif a < 8:
hr_lim, rr_lim = 140, 30
else:
hr_lim, rr_lim = 100, 20
danger = x['hr'] > hr_lim or x['rr'] > rr_lim or x['spo2'] < 92
if r >= 2 and danger:
return {'level': 2, 'upgraded': True}
return {'level': 3 if r >= 2 else 4 if r == 1 else 5, 'upgraded': False}
def check(label, actual, expected):
observations.append({"check": label, "actual": actual, "expected": expected, "passed": actual == expected})
fixtures = [[('lifesaving',
{'lifesaving': True,
'high_risk': True,
'confused': False,
'pain': 3,
'resources': 3,
'age_years': 41,
'hr': 130,
'rr': 30,
'spo2': 85},
{'level': 1, 'upgraded': False}),
('severe pain exactly 7',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 7,
'resources': 1,
'age_years': 30,
'hr': 90,
'rr': 18,
'spo2': 98},
{'level': 2, 'upgraded': False}),
('two resources normal vitals',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 4,
'resources': 3,
'age_years': 35,
'hr': 88,
'rr': 18,
'spo2': 97},
{'level': 3, 'upgraded': False}),
('one resource tachycardic stays 4',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 2,
'resources': 1,
'age_years': 25,
'hr': 106,
'rr': 18,
'spo2': 97},
{'level': 4, 'upgraded': False}),
('no resources hypoxic stays 5',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 0,
'resources': 0,
'age_years': 50,
'hr': 80,
'rr': 18,
'spo2': 89},
{'level': 5, 'upgraded': False}),
('eight-year-old uses adult limits',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 8,
'hr': 111,
'rr': 22,
'spo2': 97},
{'level': 2, 'upgraded': True}),
('twelve-year-old uses adult limits',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 3,
'age_years': 12,
'hr': 116,
'rr': 18,
'spo2': 98},
{'level': 2, 'upgraded': True}),
('preschool child within limits',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 4,
'hr': 131,
'rr': 28,
'spo2': 97},
{'level': 3, 'upgraded': False}),
('saturation exactly 92',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 61,
'hr': 80,
'rr': 18,
'spo2': 92},
{'level': 3, 'upgraded': False}),
('hypoxic child with two resources',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 1,
'hr': 120,
'rr': 25,
'spo2': 90},
{'level': 2, 'upgraded': True})],
[('lifesaving',
{'lifesaving': True,
'high_risk': True,
'confused': False,
'pain': 3,
'resources': 3,
'age_years': 42,
'hr': 130,
'rr': 30,
'spo2': 85},
{'level': 1, 'upgraded': False}),
('severe pain exactly 7',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 7,
'resources': 0,
'age_years': 30,
'hr': 90,
'rr': 18,
'spo2': 98},
{'level': 2, 'upgraded': False}),
('two resources normal vitals',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 4,
'resources': 2,
'age_years': 35,
'hr': 88,
'rr': 18,
'spo2': 97},
{'level': 3, 'upgraded': False}),
('one resource tachycardic stays 4',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 2,
'resources': 1,
'age_years': 25,
'hr': 107,
'rr': 18,
'spo2': 97},
{'level': 4, 'upgraded': False}),
('no resources hypoxic stays 5',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 0,
'resources': 0,
'age_years': 50,
'hr': 80,
'rr': 18,
'spo2': 90},
{'level': 5, 'upgraded': False}),
('eight-year-old uses adult limits',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 8,
'hr': 112,
'rr': 22,
'spo2': 97},
{'level': 2, 'upgraded': True}),
('twelve-year-old uses adult limits',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 3,
'age_years': 12,
'hr': 117,
'rr': 18,
'spo2': 98},
{'level': 2, 'upgraded': True}),
('preschool child within limits',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 4,
'hr': 132,
'rr': 28,
'spo2': 97},
{'level': 3, 'upgraded': False}),
('saturation exactly 92',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 62,
'hr': 80,
'rr': 18,
'spo2': 92},
{'level': 3, 'upgraded': False}),
('hypoxic child with two resources',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 2,
'hr': 120,
'rr': 25,
'spo2': 90},
{'level': 2, 'upgraded': True})],
[('lifesaving',
{'lifesaving': True,
'high_risk': True,
'confused': False,
'pain': 3,
'resources': 3,
'age_years': 43,
'hr': 130,
'rr': 30,
'spo2': 85},
{'level': 1, 'upgraded': False}),
('severe pain exactly 7',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 7,
'resources': 1,
'age_years': 30,
'hr': 90,
'rr': 18,
'spo2': 98},
{'level': 2, 'upgraded': False}),
('two resources normal vitals',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 4,
'resources': 3,
'age_years': 35,
'hr': 88,
'rr': 18,
'spo2': 97},
{'level': 3, 'upgraded': False}),
('one resource tachycardic stays 4',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 2,
'resources': 1,
'age_years': 25,
'hr': 108,
'rr': 18,
'spo2': 97},
{'level': 4, 'upgraded': False}),
('no resources hypoxic stays 5',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 0,
'resources': 0,
'age_years': 50,
'hr': 80,
'rr': 18,
'spo2': 89},
{'level': 5, 'upgraded': False}),
('eight-year-old uses adult limits',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 8,
'hr': 113,
'rr': 22,
'spo2': 97},
{'level': 2, 'upgraded': True}),
('twelve-year-old uses adult limits',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 3,
'age_years': 12,
'hr': 118,
'rr': 18,
'spo2': 98},
{'level': 2, 'upgraded': True}),
('preschool child within limits',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 4,
'hr': 133,
'rr': 28,
'spo2': 97},
{'level': 3, 'upgraded': False}),
('saturation exactly 92',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 63,
'hr': 80,
'rr': 18,
'spo2': 92},
{'level': 3, 'upgraded': False}),
('hypoxic child with two resources',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 3,
'hr': 120,
'rr': 25,
'spo2': 90},
{'level': 2, 'upgraded': True})],
[('lifesaving',
{'lifesaving': True,
'high_risk': True,
'confused': False,
'pain': 3,
'resources': 3,
'age_years': 44,
'hr': 130,
'rr': 30,
'spo2': 85},
{'level': 1, 'upgraded': False}),
('severe pain exactly 7',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 7,
'resources': 0,
'age_years': 30,
'hr': 90,
'rr': 18,
'spo2': 98},
{'level': 2, 'upgraded': False}),
('two resources normal vitals',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 4,
'resources': 2,
'age_years': 35,
'hr': 88,
'rr': 18,
'spo2': 97},
{'level': 3, 'upgraded': False}),
('one resource tachycardic stays 4',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 2,
'resources': 1,
'age_years': 25,
'hr': 109,
'rr': 18,
'spo2': 97},
{'level': 4, 'upgraded': False}),
('no resources hypoxic stays 5',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 0,
'resources': 0,
'age_years': 50,
'hr': 80,
'rr': 18,
'spo2': 90},
{'level': 5, 'upgraded': False}),
('eight-year-old uses adult limits',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 8,
'hr': 114,
'rr': 22,
'spo2': 97},
{'level': 2, 'upgraded': True}),
('twelve-year-old uses adult limits',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 3,
'age_years': 12,
'hr': 119,
'rr': 18,
'spo2': 98},
{'level': 2, 'upgraded': True}),
('preschool child within limits',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 4,
'hr': 134,
'rr': 28,
'spo2': 97},
{'level': 3, 'upgraded': False}),
('saturation exactly 92',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 64,
'hr': 80,
'rr': 18,
'spo2': 92},
{'level': 3, 'upgraded': False}),
('hypoxic child with two resources',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 4,
'hr': 120,
'rr': 25,
'spo2': 90},
{'level': 2, 'upgraded': True})],
[('lifesaving',
{'lifesaving': True,
'high_risk': True,
'confused': False,
'pain': 3,
'resources': 3,
'age_years': 45,
'hr': 130,
'rr': 30,
'spo2': 85},
{'level': 1, 'upgraded': False}),
('severe pain exactly 7',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 7,
'resources': 1,
'age_years': 30,
'hr': 90,
'rr': 18,
'spo2': 98},
{'level': 2, 'upgraded': False}),
('two resources normal vitals',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 4,
'resources': 3,
'age_years': 35,
'hr': 88,
'rr': 18,
'spo2': 97},
{'level': 3, 'upgraded': False}),
('one resource tachycardic stays 4',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 2,
'resources': 1,
'age_years': 25,
'hr': 110,
'rr': 18,
'spo2': 97},
{'level': 4, 'upgraded': False}),
('no resources hypoxic stays 5',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 0,
'resources': 0,
'age_years': 50,
'hr': 80,
'rr': 18,
'spo2': 89},
{'level': 5, 'upgraded': False}),
('eight-year-old uses adult limits',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 8,
'hr': 115,
'rr': 22,
'spo2': 97},
{'level': 2, 'upgraded': True}),
('twelve-year-old uses adult limits',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 3,
'age_years': 12,
'hr': 120,
'rr': 18,
'spo2': 98},
{'level': 2, 'upgraded': True}),
('preschool child within limits',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 4,
'hr': 135,
'rr': 28,
'spo2': 97},
{'level': 3, 'upgraded': False}),
('saturation exactly 92',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 65,
'hr': 80,
'rr': 18,
'spo2': 92},
{'level': 3, 'upgraded': False}),
('hypoxic child with two resources',
{'lifesaving': False,
'high_risk': False,
'confused': False,
'pain': 3,
'resources': 2,
'age_years': 5,
'hr': 120,
'rr': 25,
'spo2': 90},
{'level': 2, 'upgraded': True})]]
for label, args, expected in fixtures[N-1]:
check(label, solve(args), expected)
print(json.dumps({"observations": observations, "passed": all(x["passed"] for x in observations)}, ensure_ascii=False))
raise SystemExit(0 if all(x["passed"] for x in observations) else 1)
| Boundary fixture | Actual | Expected | Outcome |
|---|---|---|---|
| lifesaving | {'level': 1, 'upgraded': False} | {'level': 1, 'upgraded': False} | Passed |
| severe pain exactly 7 | {'level': 2, 'upgraded': False} | {'level': 2, 'upgraded': False} | Passed |
| two resources normal vitals | {'level': 3, 'upgraded': False} | {'level': 3, 'upgraded': False} | Passed |
| one resource tachycardic stays 4 | {'level': 4, 'upgraded': False} | {'level': 4, 'upgraded': False} | Passed |
| no resources hypoxic stays 5 | {'level': 5, 'upgraded': False} | {'level': 5, 'upgraded': False} | Passed |
| eight-year-old uses adult limits | {'level': 2, 'upgraded': True} | {'level': 2, 'upgraded': True} | Passed |
| twelve-year-old uses adult limits | {'level': 2, 'upgraded': True} | {'level': 2, 'upgraded': True} | Passed |
| preschool child within limits | {'level': 3, 'upgraded': False} | {'level': 3, 'upgraded': False} | Passed |
| saturation exactly 92 | {'level': 3, 'upgraded': False} | {'level': 3, 'upgraded': False} | Passed |
| hypoxic child with two resources | {'level': 2, 'upgraded': True} | {'level': 2, 'upgraded': True} | Passed |
SHA-256 / d56ef2dc4053ec6dc69f342367be6cefe0bf0fe0ff5cc59c9af54d0ea4202ac4
Verification & scope
A deterministic toy software model with explicitly stipulated thresholds and formulas; it is not clinical guidance, not a validated medical calculator, and makes no claim of conformance to any published protocol. Numbered variants vary patient and order inputs. This reproducer isolates one failure mechanism. Results cover the supplied fixtures. Variants within a family share a test contract and should remain grouped when constructing evaluation splits. Related mechanisms with a shared evaluation_group must also remain together; these controlled models are not independent production incidents.
Observations recorded using Python 3.12.14 at 2026-09-29T14:47:24.169548+00:00.
Case digest / 35678e2f18601040ae569ff805e930ea62e19f7f33b7c83214e2ea2d43a9ed4e